UCLA David Geffen School of Medicine, Los Angeles, USA.
UCLA Fielding School of Public Health, Los Angeles, USA.
BMC Med Educ. 2021 Dec 11;21(1):613. doi: 10.1186/s12909-021-03034-7.
Effective healthcare disparities curricula seek to train physicians who are well equipped to address the health needs of an increasingly diverse society. Current literature on healthcare disparities curricula and implementation focuses on courses created independent of existing educational materials. Our aim was to develop and implement a novel resource-conserving healthcare disparities curriculum to enhance existing medical school lectures without the need for additional lectures.
This non-randomized intervention was conducted at the University of California Los Angeles. The curriculum was offered to all first-year medical students in the class of 2021 (n=188). With institutional approval, a new healthcare disparities curriculum was created based on the Society of General Internal Medicine's core learning objectives for effective healthcare disparities curricula (J General Internal Med 25:S160-163, 2010). Implementation of the curriculum made use of "teachable moments" within existing medical school lectures. Teachable moments were broad lecture topics identified by the research team as suitable for introducing relevant healthcare disparities content. The new lecture-enhancing healthcare disparities curriculum was delivered with the related lecture via integrated PDF documents uploaded to an online learning management system. Students were encouraged to complete pre- and post- course assessments to examine changes in disparities knowledge and self-rated confidence in addressing disparities. Matched χ2 tests were used for statistical analysis.
Participating students (n=92) completed both pre- and post-course assessments and were retrospectively stratified, based on self-reported use of the new lecture enhancing curriculum, into the "high utilizer" group (use of materials "sometimes" or "very often," n=52) and the comparison "low utilizer" group (use of the materials "rarely" or "very rarely," n=40). Students who self-identified as underrepresented racial and ethnic minorities in medicine were more likely to utilize the material (41% of the high utilizers vs. 17% of the low utilizer group, p<.01). Post-course knowledge assessment scores and self-reported confidence in addressing healthcare disparities improved only in the high utilizer group.
Integrating new guideline based curricula content simultaneously into pre-existing lectures by identifying and harnessing teachable moments may be an effective and resource-conserving strategy for enhancing healthcare disparities education among first year medical students.
有效的医疗保健差异课程旨在培养能够满足日益多样化社会健康需求的医生。当前有关医疗保健差异课程和实施的文献主要集中在独立于现有教育材料创建的课程上。我们的目标是开发和实施一种新颖的资源节约型医疗保健差异课程，以增强现有医学院讲座，而无需增加额外的讲座。
这项非随机干预措施在加利福尼亚大学洛杉矶分校进行。该课程提供给 2021 年（n=188）所有一年级医学生。在获得机构批准的情况下，根据一般内科医师学会（Society of General Internal Medicine）针对有效医疗保健差异课程的核心学习目标（J General Internal Med 25：S160-163，2010），为新的医疗保健差异课程创建了新的课程。该课程的实施利用了现有医学院讲座中的“可教时刻”。可教时刻是研究团队确定的适合引入相关医疗保健差异内容的广泛讲座主题。通过将相关讲座上传到在线学习管理系统的集成 PDF 文档，提供了增强讲座的新的医疗保健差异课程。鼓励学生完成课程前后的评估，以检查差异知识的变化以及自我评估解决差异的能力。使用匹配的 χ2 检验进行统计分析。
参与的学生（n=92）完成了课程前后的评估，并根据自我报告的使用新的讲座增强课程的情况进行了回顾性分层，分为“高利用率”组（“有时”或“经常”使用材料，n=52）和比较“低利用率”组（“很少”或“很少”使用材料，n=40）。自认为在医学领域代表性不足的少数族裔和族裔的学生更有可能使用该材料（高利用率组中有 41％，而低利用率组中有 17％，p<.01）。仅在高利用率组中，课程后的知识评估分数和自我报告的解决医疗保健差异的能力有所提高。
通过识别和利用可教时刻，同时将新的基于指南的课程内容整合到现有课程中，可能是增强一年级医学生医疗保健差异教育的有效且节约资源的策略。
